Headaches: Should I Take Prescription Medicine for Tension Headaches?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Headaches: Should I Take Prescription Medicine for Tension Headaches?

1

2

3

4

5

6

Get the facts

Your options

Take a daily prescription medicine to help prevent your tension
headaches.

Don't take a daily prescription medicine. Instead, treat your tension
headaches only when you have them.

Key points to remember

If your
tension headaches are mild to moderate, first try an
over-the-counter pain medicine, such as aspirin,
ibuprofen, naproxen, or acetaminophen.

If nonprescription
medicines don't work to stop your headaches, or if you take them more than 3
times a week or have a headache more than 15 days a month, your doctor may
recommend you take a prescription medicine every day to help prevent headaches.

Even with treatment, you may still get some
tension headaches. But when you do get them, they may not be as bad or last as
long.

There are different
kinds of headaches. Most people get
tension headaches. When you have a tension headache,
you may feel a constant ache, tightness, and pressure around your forehead,
temples, or the back of your head and neck. It may feel like your head is in a
vise.

Tension headaches usually cause mild to moderate pain. Most
of the time, they aren't bad enough to stop you from doing your daily tasks.
But some people have very bad headaches that last a long time. These headaches
can disrupt your life.

Tension headaches tend to come back,
especially when you're under
stress. They can last from 30 minutes to several
days.

If you have tension headaches for 15 days or more a month for
3 months, you may have
chronic tension headaches. Some people who have
chronic headaches also have
anxiety and
depression.

The cause of tension headaches is not clear. Doctors
used to think that these headaches were caused by tension or spasms in the
muscles of the neck, face, jaw, or head. Now they think that a change in brain
chemicals may also cause these headaches.

First try
over-the-counter pain medicines to manage your
headaches. Be safe with medicines. Read
and follow all instructions on the label.

Nonprescription medicines for headaches include:

Acetaminophen (such
as Tylenol).

Aspirin (such as Bayer).

Ibuprofen (such as Advil).

Naproxen (such as Aleve).

Combination medicine that includes aspirin,
acetaminophen, and caffeine (such as Excedrin).

If the nonprescription medicines above don't
work to stop your headaches, or if you take them more than 3 times a week or
have a headache more than 15 days a month, your doctor may recommend you take a
prescription medicine every day to help prevent headaches.

Your doctor may
also suggest ways to reduce
stress and
anxiety as a way to manage your headaches.

You'll need to take medicine every day, even when
you don't have a headache.

If you don't feel better after a few
weeks of taking the medicine, talk to your doctor. You may need to try several
different medicines to find one that works for you.

The medicine
can cause side effects. Some of these side effects may last for a few weeks or
for as long as you take the medicine. You may need to decide which bothers you
more, the side effects of the medicine or your headaches.

Common
side effects include:

Dry
mouth.

Constipation.

Blurred
vision.

Inability to urinate.

Weight gain.

Low blood pressure when you stand up quickly.

Serious side effects can also happen. When taken during pregnancy, anticonvulsants can cause birth defects.

What else can you do to manage your tension headaches?

Some people find other ways to manage headaches besides taking medicine.
These include:

Acupuncture. Tiny needles are put into certain points
on your skin to relieve pain. Current evidence shows that acupuncture can help
prevent tension headaches.footnote 4

Biofeedback. With this treatment, you can learn to
control a body function that is not normally under your conscious control, such
as breathing or muscle tension.

Cognitive-behavioral therapy or
problem-solving therapy. This
kind of counseling can help you reduce stress and anxiety.

Relaxation exercises. These help you learn how to relax each muscle group.

Electrical nerve stimulation. A
mild electrical current is used on specific parts of your body to help treat
pain.

Peppermint oil. There is some evidence that
peppermint oil rubbed on the temples or on the tight muscles in the head, neck,
and shoulders may help relieve tension headaches.

Here are some things you can do at home:

Figure out what may cause your tension
headaches. Is it stress, anxiety, fatigue, hunger, anger, poor posture, or eye
or muscle strain? Are you doing too much? It may help to keep a
headache diary to track how often you have tension
headaches, how painful they are, and what you think might be causing
them.

You use over-the-counter medicines to stop a
headache more than 3 times a week.

Your tension headache lasts 7 days or more.

You
have tried over-the-counter medicines, but they don't help.

Compare your options

Compare

What is usually involved?

What are the benefits?

What are the risks and side effects?

Take prescription
medicine to help prevent tension headaches Take prescription
medicine to help prevent tension headaches

You take medicine every
day, even if you don't have a headache.

You may still try over-the-counter medicines to stop headaches that you do get.

You may also use other
treatments that help to reduce stress and anxiety.

You still try to avoid things that may trigger your tension
headaches, such as stress, anxiety, and muscle strain.

Benefits include:

Fewer or no tension
headaches.

Shorter headaches.

Headaches that aren't as
severe.

Possible side effects include:

Dry
mouth.

Constipation.

Blurred
vision.

Inability to urinate.

Weight gain.

Low blood pressure when you stand up quickly.

Don't take prescription
medicine to help prevent your headaches Don't take prescription
medicine to help prevent your headaches

You may try
over-the-counter medicines to manage your
headaches.

You may also use other treatments that help to reduce stress and anxiety.

You try to avoid things that may trigger your tension
headaches, such as stress, anxiety, and muscle strain.

If your
symptoms don't improve with other medicines, counseling, or home treatment, you
can decide later to try prescription medicine.

You avoid the side
effects of the medicine.

You don't have to take medicine every day.

You continue to get tension headaches.

If
your symptoms are severe, you may miss several days of work or school.

Personal stories about taking medicines for tension headaches

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

My job requires me to spend a lot of time in front of a computer
screen, and my eyes are sore at the end of most days. I also have a lot of
stress in my life right now. I am getting frequent tension headaches, but an
aspirin usually relieves the pain. I'm keeping a headache diary to see how
often I get these headaches. I am going to try putting a filter on my computer
screen and taking frequent breaks. I've also signed up for a yoga class to help
me relax. If I continue to have tension headaches, I will take my headache
diary to my doctor and see if I need stronger medicines.

Joyce, age 34

Recently I've been getting tension headaches almost
daily. I take naproxen and sometimes aspirin whenever I get a headache. My headaches go
away for awhile but then come back within a couple of hours after I take these
pain relievers. My doctor said I might be getting rebound headaches from taking
too many pain relievers. She thinks I should try taking prescription medicine every day to
prevent my headaches. I think I will take her advice and see if I can get these
headaches under control.

John,
age 45

I have had a lot of changes in my life
recently. I started getting headaches around the time we moved to a new town.
My mom thinks they are related to stress and will go away when I feel
comfortable at my new home and school. Sometimes I need to take an ibuprofen
for the headache, but not always. I am learning how to do relaxation exercises
at a class I'm taking, and this seems to help. My parents talked about it and
decided to wait for a month to see if the headaches go away before taking me to
the doctor.

Leslie, age
14

I have been getting tension headaches for
more than 7 months. I decided to start keeping a diary of how often I get them
to try to identify any triggers. So far, it looks like I get headaches around
20 days out of every month, but I'm not sure why. While I don't miss a lot of
time away from work, I do think my productivity is suffering. I've tried
biofeedback to see if I could reduce stress, but that hasn't helped. My doctor
thinks it is time for me to try an antidepressant to prevent tension headaches
from occurring. I think I'll give that a try.

Jennifer, age 35

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take prescription medicine for tension headaches

Reasons not to take prescription medicine for tension headaches

I'm willing to take medicine every day, because I think it will help ease my tension headaches.

I want to take medicine only when I have a headache.

More important

Equally important

More important

I don't think the side effects of the medicine could be as bad as my tension headaches.

I think the side effects of the medicine would bother me more than my headaches.

More important

Equally important

More important

My tension headaches are affecting my work and relationships with friends and family.

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking prescription medicine for tension headaches

NOT taking prescription medicine for tension headaches

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.1, If I only get tension headaches every now and then, and if they don't bother me too much, I should take prescription medicine every day to treat them.

TrueSorry, that's not right. Doctors recommend that you first try an over-the-counter pain medicine, such as aspirin, ibuprofen, naproxen, or acetaminophen, before you try a prescription medicine.

FalseThat's right. Doctors recommend that you first try an over-the-counter pain medicine, such as aspirin, ibuprofen, naproxen, or acetaminophen, before you try a prescription medicine.

I'm not sureIt may help to go back and read "Get the Facts." Doctors recommend that you first try an over-the-counter pain medicine before you try a prescription medicine.

2.2, I may still get tension headaches, even though I'm taking medicine to prevent them.

TrueThat's right. You may still get some tension headaches. But when you do get them, they may not be as bad or last as long.

FalseSorry, that's not right. You may still get some tension headaches. But when you do get them, they may not be as bad or last as long.

I'm not sureIt may help to go back and read "Get the Facts." You may still get some tension headaches. But when you do get them, they may not be as bad or last as long.

3.3, If I don't want to take medicine to treat my tension headaches, I can try other kinds of treatment that may help me feel better.

TrueThat's right. There are other things you can try that don't involve taking medicine every day, such as using cognitive-behavioral therapy and biofeedback.

FalseSorry, that's not right. There are other things you can try that don't involve taking medicine every day, such as using cognitive-behavioral therapy and biofeedback.

I'm not sureIt may help to go back and read "Get the Facts." There are other things you can try that don't involve taking medicine every day, such as using cognitive-behavioral therapy and biofeedback.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Headaches: Should I Take Prescription Medicine for Tension Headaches?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Take a daily prescription medicine to help prevent your tension
headaches.

Don't take a daily prescription medicine. Instead, treat your tension
headaches only when you have them.

Key points to remember

If your
tension headaches are mild to moderate, first try an
over-the-counter pain medicine, such as aspirin,
ibuprofen, naproxen, or acetaminophen.

If nonprescription
medicines don't work to stop your headaches, or if you take them more than 3
times a week or have a headache more than 15 days a month, your doctor may
recommend you take a prescription medicine every day to help prevent headaches.

Even with treatment, you may still get some
tension headaches. But when you do get them, they may not be as bad or last as
long.

The medicine you take may
cause side effects. Some of these side effects may last for a few weeks or for
as long as you take the medicine.

FAQs

What is a tension headache?

There are different
kinds of headaches. Most people get
tension headaches. When you have a tension headache,
you may feel a constant ache, tightness, and pressure around your forehead,
temples, or the back of your head and neck. It may feel like your head is in a
vise.

Tension headaches usually cause mild to moderate pain. Most
of the time, they aren't bad enough to stop you from doing your daily tasks.
But some people have very bad headaches that last a long time. These headaches
can disrupt your life.

Tension headaches tend to come back,
especially when you're under
stress. They can last from 30 minutes to several
days.

If you have tension headaches for 15 days or more a month for
3 months, you may have
chronic tension headaches. Some people who have
chronic headaches also have
anxiety and
depression.

The cause of tension headaches is not clear. Doctors
used to think that these headaches were caused by tension or spasms in the
muscles of the neck, face, jaw, or head. Now they think that a change in brain
chemicals may also cause these headaches.

How are tension headaches treated?

First try
over-the-counter pain medicines to manage your
headaches. Be safe with medicines. Read
and follow all instructions on the label.

Nonprescription medicines for headaches include:

Acetaminophen (such
as Tylenol).

Aspirin (such as Bayer).

Ibuprofen (such as Advil).

Naproxen (such as Aleve).

Combination medicine that includes aspirin,
acetaminophen, and caffeine (such as Excedrin).

If the nonprescription medicines above don't
work to stop your headaches, or if you take them more than 3 times a week or
have a headache more than 15 days a month, your doctor may recommend you take a
prescription medicine every day to help prevent headaches.

Your doctor may
also suggest ways to reduce
stress and
anxiety as a way to manage your headaches.

What prescription medicines can you take to help prevent tension headaches?

Your
doctor may have you try one of more of the following medicines to help prevent
your headaches:

Antidepressants, such as amitriptyline.

Seizure medicines, such as gabapentin, topiramate, and valproate.

Antianxiety medicines, such as buspirone.

Often
the best way to treat chronic tension headaches is to use medicine along with
treatments that reduce stress and anxiety, such as
cognitive-behavioral therapy.

How well do these medicines work?

Even with
treatment, you may still get some tension headaches. But studies have shown
that:

When you take them each day, antidepressants like amitriptyline can reduce how often you
get tension headaches and how bad they get.1

Seizure medicines may be able to reduce
how often you get tension headaches and how long they last.2

The antianxiety medicine buspirone may be able to reduce
how often you get tension headaches by reducing anxiety.

What can you expect if you take prescription medicine for tension headaches?

You'll need to take medicine every day, even when
you don't have a headache.

If you don't feel better after a few
weeks of taking the medicine, talk to your doctor. You may need to try several
different medicines to find one that works for you.

The medicine
can cause side effects. Some of these side effects may last for a few weeks or
for as long as you take the medicine. You may need to decide which bothers you
more, the side effects of the medicine or your headaches.

Common
side effects include:

Dry
mouth.

Constipation.

Blurred
vision.

Inability to urinate.

Weight gain.

Low blood pressure when you stand up quickly.

Serious side effects can also happen. When taken during pregnancy, anticonvulsants can cause birth defects.

What else can you do to manage your tension headaches?

Some people find other ways to manage headaches besides taking medicine.
These include:

Acupuncture. Tiny needles are put into certain points
on your skin to relieve pain. Current evidence shows that acupuncture can help
prevent tension headaches.4

Biofeedback. With this treatment, you can learn to
control a body function that is not normally under your conscious control, such
as breathing or muscle tension.

Cognitive-behavioral therapy or
problem-solving therapy. This
kind of counseling can help you reduce stress and anxiety.

Relaxation exercises. These help you learn how to relax each muscle group.

Electrical nerve stimulation. A
mild electrical current is used on specific parts of your body to help treat
pain.

Peppermint oil. There is some evidence that
peppermint oil rubbed on the temples or on the tight muscles in the head, neck,
and shoulders may help relieve tension headaches.

Here are some things you can do at home:

Figure out what may cause your tension
headaches. Is it stress, anxiety, fatigue, hunger, anger, poor posture, or eye
or muscle strain? Are you doing too much? It may help to keep a
headache diary to track how often you have tension
headaches, how painful they are, and what you think might be causing
them.

You use over-the-counter medicines to stop a
headache more than 3 times a week.

Your tension headache lasts 7 days or more.

You
have tried over-the-counter medicines, but they don't help.

2. Compare your options

Take prescription
medicine to help prevent tension headaches

Don't take prescription
medicine to help prevent your headaches

What is usually involved?

You take medicine every
day, even if you don't have a headache.

You may still try over-the-counter medicines to stop headaches that you do get.

You may also use other
treatments that help to reduce stress and anxiety.

You still try to avoid things that may trigger your tension
headaches, such as stress, anxiety, and muscle strain.

You may try
over-the-counter medicines to manage your
headaches.

You may also use other treatments that help to reduce stress and anxiety.

You try to avoid things that may trigger your tension
headaches, such as stress, anxiety, and muscle strain.

What are the benefits?

Benefits include:

Fewer or no tension
headaches.

Shorter headaches.

Headaches that aren't as
severe.

If your
symptoms don't improve with other medicines, counseling, or home treatment, you
can decide later to try prescription medicine.

You avoid the side
effects of the medicine.

You don't have to take medicine every day.

What are the risks and side effects?

Possible side effects include:

Dry
mouth.

Constipation.

Blurred
vision.

Inability to urinate.

Weight gain.

Low blood pressure when you stand up quickly.

You continue to get tension headaches.

If
your symptoms are severe, you may miss several days of work or school.

Personal stories

Personal stories about taking medicines for tension headaches

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"My job requires me to spend a lot of time in front of a computer screen, and my eyes are sore at the end of most days. I also have a lot of stress in my life right now. I am getting frequent tension headaches, but an aspirin usually relieves the pain. I'm keeping a headache diary to see how often I get these headaches. I am going to try putting a filter on my computer screen and taking frequent breaks. I've also signed up for a yoga class to help me relax. If I continue to have tension headaches, I will take my headache diary to my doctor and see if I need stronger medicines."

— Joyce, age 34

"Recently I've been getting tension headaches almost daily. I take naproxen and sometimes aspirin whenever I get a headache. My headaches go away for awhile but then come back within a couple of hours after I take these pain relievers. My doctor said I might be getting rebound headaches from taking too many pain relievers. She thinks I should try taking prescription medicine every day to prevent my headaches. I think I will take her advice and see if I can get these headaches under control."

— John,
age 45

"I have had a lot of changes in my life recently. I started getting headaches around the time we moved to a new town. My mom thinks they are related to stress and will go away when I feel comfortable at my new home and school. Sometimes I need to take an ibuprofen for the headache, but not always. I am learning how to do relaxation exercises at a class I'm taking, and this seems to help. My parents talked about it and decided to wait for a month to see if the headaches go away before taking me to the doctor."

— Leslie, age
14

"I have been getting tension headaches for more than 7 months. I decided to start keeping a diary of how often I get them to try to identify any triggers. So far, it looks like I get headaches around 20 days out of every month, but I'm not sure why. While I don't miss a lot of time away from work, I do think my productivity is suffering. I've tried biofeedback to see if I could reduce stress, but that hasn't helped. My doctor thinks it is time for me to try an antidepressant to prevent tension headaches from occurring. I think I'll give that a try."

— Jennifer, age 35

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take prescription medicine for tension headaches

Reasons not to take prescription medicine for tension headaches

I'm willing to take medicine every day, because I think it will help ease my tension headaches.

I want to take medicine only when I have a headache.

More important

Equally important

More important

I don't think the side effects of the medicine could be as bad as my tension headaches.

I think the side effects of the medicine would bother me more than my headaches.

More important

Equally important

More important

My tension headaches are affecting my work and relationships with friends and family.

Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.